痰热清注射液联合纤维支气管镜对呼吸机相关性肺炎患者呼吸力学、炎性因子及氧化应激的影响  

Effect of Tanreqing injection combined with fiber bronchoscope on respiratory mechanics,inflammatory factors and oxidative stress in patients with ventilator-associated pneumonia

作　　者：李连生[1] 李芃菲 陶素梅[2] 靳丽丽[1] Lt Liansheng LI Pengfei TAO Sumei QIN Lili(The Seventh People＇ s Hospital of Hebei Province, Dingzhou 073000, Hebei, China The Fourth Hospital of Shijiazhuang, Shijiazhuang 050000, Hebei, China)

机构地区：[1]河北省第七人民医院,河北定州073000 [2]河北省石家庄市第四医院,河北石家庄050000

出　　处：《现代中西医结合杂志》2017年第29期3208-3211,共4页Modern Journal of Integrated Traditional Chinese and Western Medicine

摘　　要：目的观察痰热清注射液联合纤维支气管镜对呼吸机相关性肺炎(VAP)患者呼吸力学、炎性因子及氧化应激的影响。方法将100例VAP患者随机分为观察组50例及对照组50例,对照组给予纤维支气管镜治疗,观察组在对照组治疗基础上给予痰热清注射液治疗,2组均治疗7 d。观察2组治疗前后体温、血氧饱和度[Sp(O_2)]、乳酸(Lac)、感染指数评分(CPIS)及呼吸力学、氧化应激反应、炎性因子变化情况。结果 2组治疗后体温、Lac、Sp(O_2)及CPIS评分均显著改善(P均<0.05),呼吸机呼吸力学参数气道峰压(PIP)、气道阻力(Raw)及呼吸做功(WOB)均显著降低而动脉顺应性(Cdyn)显著升高(P均<0.05),且观察组上述指标改善情况均显著优于对照组(P均<0.05);2组治疗后血清超氧化物歧化酶(SOD)、总氧化能力(TAC)及谷胱甘肽(GSH)水平均显著升高而丙二醛(MDA)水平和血清IL-1β、IL-8、TNF-α、PCT水平均显著降低(P均<0.05),且观察组上述指标改善情况均显著优于对照组(P均<0.05)。结论痰热清注射液联合纤维支气管镜能够控制改善VAP患者的肺部感染程度,改善患者呼吸功能,并有效抑制患者机体氧化应激及炎性状态。Objective It is to observe the effects of Tanreqing injection combined with fiber bronchoscope on respiratory mechanics, inflammatory factors and oxidative stress in patients with ventilator-associated pneumonia（ VAP）. Methods 100 patients with VAP were randomly divided into observation group （ n = 50） treated with Tanreqing injection ＋ fiber bronchoscope and control group （ n = 50） treated with fiber bronchoscope, both groups were treated for 7 days. The changes of temperature, lactate （Lae） , blood oxygen saturation [ Sp（ O2 ） ] , infection index score （CPIS） and respiratory mechanics, oxidative stress response, and inflammatory factors before and after treatment were observed in both groups. Results After treatment tempera- ture, Lac, Sp（ O2 ） and CPIS scores were improved significantly （P 〈 0.05 ） , the ventilator breathing mechanics parameters such as airway peak pressure （PIP） , airway resistance （Raw） and the work of breathing （WOB） were reduced, arterial compliance （Cdyn） was increased in both groups （P 〈 0.05）; the levels of serum SOD, TAC and GSH were significantly increased while that of MDA, IL-1 beta, IL-8, TNF- alpha and PCT were decreased significantly in both groups （P 〈 0.05 ） ; the improvements of these indexes above in the observation group were better than those in the control group （ P 〈 0.05 ）. Conclusion Tanreqing injection combined with fiber bronchoscope can improve the degree of lung infection and respiratory function, and inhibit oxidative stress and inflammatory reaction in patients with VAP.

关 键 词：痰热清注射液 纤维支气管镜 呼吸机相关性肺炎 呼吸力学 氧化应激 炎性反应 

分 类 号：R563.1[医药卫生—呼吸系统]